by Amy Shojai
as much as possible. You have to find out what motivates the cat.”
Use a treat, a feather toy, the beam from a flashlight or some other
enticement to lure him into action. Fishing-pole toys work wel for
many cats. Avoid making him leap for the lure, which can jar the joints.
Keep the toy on the ground so that he can stalk and chase and
pounce but doesn’t overdo.
Ten minutes several times a day is a good start, says Dr.
Conzemius. Smal amounts of daily are much better than marathon
sessions once a week. Massage before and after exercise can help
keep muscles from tightening, which can make your cat reluctant to
get off his furry tail. It also doubles as a nice bonding exercise.
Nurse Alert!
A number of arthritis medications are available. Nearly al are in
pil form, and wil require you to pil your cat one or more times a
day.
Many cats enjoy and benefit from massage, especial y from
someone they love.
Fol owing surgery, you may be required to keep incisions or
bandages clean, restrict your cat’s movement, or encourage him
in physical therapy activities.
Medication
Each arthritis medication has advantages and disadvantages, says
Dr. Cook. What works best for your cat may not be helpful for another,
but you won’t know until you try. General y he recommends a three-
week trial on any medication. The results are monitored, and if it’s not
working, another drug can be tried.
NSAIDs—nonsteroidal anti-inflammatory drugs—are a class of
medication that can real y help arthritic dogs and people. Aspirin is
the best known of these. The drugs work by affecting the production of
certain enzymes that are involved in joint inflammation and pain.
But cats are much more difficult to treat for pain because they lack
the enzyme that breaks down many of the most common NSAIDs,
says Dr. Linn. “Consequently, cats can be poisoned by a number of
analgesics. Tylenol kil s cats, and aspirin isn’t so hot either.”
Aspirin can be given to cats but only under a veterinarian’s
supervision, and care must be taken not to overdose. It’s not the best
choice for pain relief anyway—Dr. Little says aspirin is effective only in
relatively mild cases of arthritis. Carprofen, trade name Rimadyl, is
approved for dogs and with care it can be used off-label in cats. “I
don’t use Rimadyl in cats, but some people do,” she says.
“Metacam (meloxicam), made by Janssen Animal Health, is another
one licensed for dogs but there is a feline dose,” says Dr. Little. The
manufacturer’s feline recommendations cal for an initial injection (0.2
mg/kg) fol owed by a daily oral dose (0.1 mg/kg) for 4 days. “There is
an oral liquid form of Metacam available in Canada,” she says. “It is
hard to recommend meloxicam for chronic conditions, since cats are
very sensitive to the gastric and renal side effects of these
nonsteroidal anti-inflammatory drugs.”
Dr. Linn says Ketoprofen is probably the most commonly used
NSAID in cats. It’s also currently used off-label. “It certainly isn’t
approved for use in cats, but a lot of the folks I know who medicate
cats with analgesics have liked it.”
Another group of drugs--steroids--can help ease feline arthritis pain.
“Cats are very steroid-tolerant as a species,” says Dr. Little.
“Occasional y I’l use prednisone for advanced high inflammatory
effect, because cats tolerate prednisone on the whole better than
most of the NSAIDs and you have less risk of a problem with
prednisone in a cat.” The dose varies, but general y the lowest dose
possible that keeps them comfortable is given.
According to Sharon C. Kerwin, DVM, a veterinary surgeon at
Texas A&M University, narcotics can help manage feline arthritis pain,
particularly acute
flare-ups or after failure of an NSAID. Buprenorphine has been
demonstrated to be effective in cats, and oral liquid morphine also
has been used, although many cats dislike the taste. She says that
sustained release morphine used frequently to treat arthritis pain in
dogs is not yet available in a useful form for the cat. Dr. Kerwin also
suggests that doxycycline can prove very useful, with some pets
responding dramatical y to the drug.
Feeding For Health
Reduced-calorie diets are helpful to slim down an overweight cat and
help take the strain off arthritic joints. Regular “senior” formulas may
do the trick, but in some cases a veterinary-supervised diet is
required. Some foods also contain ingredients designed to help ease
the discomfort of achy joints. Some options include:
Eukanuba Adult Weight Control Formula
Hil ’s Prescription Diet Feline j/d (joint diet)
Hil ’s Prescription Diet Feline r/d (reduction diet)
Hil ’s Prescription Diet Feline w/d (weight diet)
Iams Veterinary Formulas Weight Loss - Restricted-Calorie/Feline
IVD (ROYAL CANIN) Select Care Feline Weight Formula
Nutro Max Weight Control Formula
Nutro Max Cat Lite
Precise Feline Light Formula
Purina Veterinary Diets, OM Overweight Management Formula
Royal Canin Veterinary Diet Feline Calorie Control Diet
Nutraceuticals
Today a variety of nutritional supplements—nutraceuticals—are
used like drugs to treat a wide range of health conditions. Also cal ed
“functional foods,” these substances maintain or improve health
beyond what ordinary nutrients in the food provide. Nutraceuticals
include herbs, enzymes, animal extracts (i.e., liver), and other
chemical compounds such as vitamins or microbial products including
“good” bacteria found in yogurt, for example.
Some of the newest “senior” diets contain nutraceuticals said to
benefit joint health. You can also add appropriate supplements to your
cat’s diet. For example, Dr. Linn says essential fatty acids, specifical y
the omega 3 fatty acids, can al eviate arthritis pain. “A lot of folks
prescribe a combination supplement cal ed DermCaps,” she says.
Products that contain green-lipped mussels (perna mussel), such as
Glyco-Flex, are helpful because they contain glucosamine-like
compounds. They also smel fishy, which is very helpful when trying to
medicate cats.
Special “joint diets” are also available, such as Hil ’s
Prescription Diet Feline j/d. These diets typical y contain high levels
of omega-3 fatty acids, alpha linoleic acid, carnitine, various
antioxidants and glucosamine/chondroitin sulfate.
Glucosamine/chondroitin sulfate is a group of compounds are
thought to help diseased cartilage work a little better, and may slow or
stop the progression of arthritis. “We’ve actual y done some of the
research here and other labs have verified that ...glucosamines work
as an antidegradative,” he says. He particularly likes using these
products because they have no side effects and can be used
alongside other medications.
Dr. Little agrees. “Glucosamine and those related products hav
e
been used in cats for a long time.” Compounds such as chondroitin
and glucosamine also have anti-inflammatory properties, says Dr.
Conzemius. “They can reduce swel ing, and that can help with the
pain.” Some products work better than others. “The glucosamine HCL
is probably the best,” says Dr. Cook, because it’s better absorbed
into the joint compared to the others.
You can buy Glucosamine HCL or other products over the counter,
but you should be aware that the nutraceutical industry is not wel
regulated. The effectiveness and quality of products varies greatly
from brand to brand, says Dr. Linn, and not al the label claims on
products have been found to be truthful. A glucosamine and
chondroitin sulfate combination product, cal ed Cosequin, is one of
the few that’s actual y been tested in scientific trials, and it is most
often recommended by veterinarians. It is, however, more expensive
than many health food products.
Dr. Cook suggests looking on the label specifical y for 500-
mil igram dosage of glucosamine HCL. The general dose is about 10
mil igrams per pound of body weight, twice a day—so a 15-pound cat
would get a total of a third of a 500-mil igram capsule once each day.
“With the glucosamine in cats, you sometimes you have to break up
the capsules, or you can get somebody to compound it. I’ve not seen
[over the counter products dosed] below 500,” says Dr. Cook. “Once
we’re getting a good effect, then we try and figure out the minimal
dose that’s effective, and back them off over time.”
Dr. Kerwin says injections of Adequan (polysulfated
glycosaminoglycan) at two mg/kg IM every three to five days for four
treatments and Cosequin (chondroitin sulfate, glucosamine and
manganese given oral y) work wel as a treatment plan for cats.
Cosequin comes as a tasty powder you sprinkle over the cat’s food. It
takes several weeks for the Cosequin to begin to work, but the
Adequan results in measurable improvement within a few days, so the
veterinarian may choose to use both together. The response is quite
individual, with some cats showing dramatic improvement while
others don’t seem to have any measurable change.
Comfort Zone
Stair steps or stools help arthritic cats reach the bed or cat tree
perch when they can no longer make that leap. Commercial
ramps are available in different sizes, but it’s simplest and most
economical to position a chair, hassock, or cardboard box for
access.
Move food bowls and litter boxes to an accessible location to
eliminate the need to jump up or down for dinner. Set the bowl
on a shirt box so the cat won’t have to bend his sore neck clear
to the ground.
Cut down the high sides of litter boxes, or provide a low-sided
pan, so arthritic cats can more easily climb in and out.
Cats love basking in a puddle of sunlight, and heat helps relieve
joint pain and keeps the cat more limber. Heated beds help
ease the pain of achy stiff joints, or you can use a wel -shielded
(with a blanket) heating pad. Several orthopedic and heated cat
pads, beds, and snugglers are available from pet product
outlets.
The Snuggle Safe plate-size pad (available from Drs. Foster &
Smith) can be microwaved, then slipped beneath the cat’s bed
to warm without electricity. Or you can fil a couple of socks with
dry uncooked rice and microwave. They’l hold the heat and
work great as kitty bed-warmers.
Situate a lighted lamp above the cat’s bed to provide an
economical and effective heat lamp.
Fil a box with towels or blankets fresh from the dryer once a day
for five minutes to warm up the muscles and relieve stiffness and
pain.
Acupuncture & Therapeutic Laser
Acupuncture is not a drug, but can act like one to relieve the pain of
arthritis. It can be used with drugs, or neutraceuticals such as
Cosequin. “Acupuncture is a good choice for arthritis in cats,” says Dr.
Little. The insertion of needles in proscribed locations throughout the
body prompts the release of natural painkil ers cal ed endorphins.
Most cats tolerate these needles quite wel .
“Some animals don’t tolerate the medication, or the owners don’t
like medication,” says Dr. Fortney. “As long as the diagnosis has
been made and there is some science, I’ve seen some success with
acupuncture. It’s a matter of combining whatever it takes to improve
the quality of life. I think that’s very appropriate.”
Acupuncture is particularly helpful for cats because it has no side
effects, says Dr. Linn. “It’s very noninvasive, it’s safe.” Be sure you
work with a veterinarian certified in acupuncture to ensure the most
benefits to your cat.
Laser therapy also offers a pain relief option for pets. They’re used
for arthritis discomfort, post-surgical pain, and enhanced healing.
Class IV therapeutic lasers are FDA-approved and considered to be
of minimal risk to both patient and operator. Plus, they're nontoxic and
are associated with essential y no side effects.
Surgical Treatment
Cats almost always do quite wel with the triad strategy, so that
should always be tried first before surgery, says Dr. Conzemius, but it
is a viable option when medical management isn’t enough. Today,
more owners than ever before pursue advanced treatments such as
surgery. “There’s more surgeons that can do these techniques, so it’s
more available to people. And owners are becoming better informed
about what the disease is and the treatment options.”
Femoral Head Ostectomy (FHO)
Cats with severe arthritis in their hips have worn the cartilage right
off the bones. “It always looks to me like that highly polished marble in
lobbies. You can imagine that hurts,” says Dr. Linn. There’s no
cartilage left to protect with nutraceuticals or anything else.
The state-of-the-art surgery for dogs is a total hip replacement in
which the joint is completely replaced with prosthetics. “Joint
replacement in cats would be difficult,” says Dr. Conzemius.
Prosthetic joints are not made smal enough to benefit cats. “There
are other surgical options that can be considered,” he says, “for
example, femoral head and neck excision for the hip [also cal ed
femoral head excision arthroplasty].” This eliminates the bone-on-
bone rubbing.
The surgeon removes the bal part of the bal and socket joint in the
hip, and closes the joint capsule over the socket. Cats form a little pad
of scar tissue, and the hip joint is then supported entirely by the
muscles. “It’s a highly successful procedure, very good at getting
animals out of pain,” says Dr. Linn. The success rate is between 80-
to 85 percent. Many veterinarians in general practice are very familiar
with FHO, so it doesn’t require going to a special center for
orthopedics.
Cats may be prescribed a narcotic-like drug cal ed butorphanol for
postoperative pain relief, s
ays Dr. Linn. “It makes cats smile. Makes
them
purr,
they love butorphanol.” Another option, fentanyl
(Duragesic), is a narcotic that is administered by means of a skin
patch. “We don’t usual y keep an animal on narcotics for arthritic pain
long-term. But it can be useful if they’ve been injured or have had
surgery,” says Dr. Linn.
Bottom Line
The cost for arthritis treatment varies depending on the specific
product, procedure, and part of the country in which you live.
Cats are much smal er than most dogs, which means medicine
dosed by weight often is much more economical for them.
Cosequin, for example, would cost approximately $6 a month for
a 15-pound cat.
“A femoral neck and head excision (FHO) runs about $1,100
per side at University of Wisconsin,” says Dr. Linn. It would likely
cost quite a bit less performed in a general practitioner’s office.
Golden Moments: Accommodating Punkin
Michel e West of Toronto was breeding and showing Abyssinians
when she attended a cat show and saw her first Scottish Fold. “She
was the most beautiful cat I’d ever seen,” says Michel e. The breed is
known for the endearing ears that fold forward toward the face and
look like a little cap on the cat’s head. “I cal ed the lady who raised her,
I just had to have a kitten.” When the lovely folded mother cat had a
litter in September, Michel e chose a calico baby when she was four
months old, and named her Punkin. “It was love at first sight!” she
says, and Michel e has been breeding Scottish Folds ever since.
Punkin celebrated her thirteenth birthday last year. “She is a
typical Scottish Fold, very sweet and loving, and a real mushy kind of
cat. But she was raised with a group of rowdy Bengals, so she’s
scared of everything.” Bengal cats tend to be rambunctious and
outgoing, and they must have taught Punkin early in her life to avoid
noisy situations.
Michel e first noticed that Punkin was walking stiffly when she was
about five years old. The condition has become progressively worse
the older she’s grown. “Scottish Folds are prone to having various
joint problems,” she says. The natural mutation that causes the
cartilage in the ears to fold may also predispose to other cartilage or